Cardiac Surgery Certification Exam Aortic Surgery and Mechanical Circulatory Support 2

Question 1

The primary indication for the Impella device in cardiac surgery patients is:

Accepted Answer

Mechanical support for cardiogenic shock or high-risk procedures requiring LV unloading

Answer

The Impella is an axial flow pump placed across the aortic valve to actively unload the LV and provide hemodynamic support in cardiogenic shock or high-risk interventions.

Question 2

Extracorporeal membrane oxygenation (ECMO) in adult cardiac surgery is used primarily as:

Accepted Answer

Rescue therapy for refractory cardiogenic shock or cardiac arrest unresponsive to conventional support

Answer

VA-ECMO provides both cardiac and respiratory support as a bridge to recovery or decision in patients with refractory cardiogenic shock after cardiac surgery.

Question 3

The most important complication to monitor for in patients on veno-arterial ECMO after cardiac surgery is:

Accepted Answer

Limb ischemia from the femoral arterial cannula and left ventricular distension

Answer

Femoral arterial cannulation can cause distal limb ischemia, and the ECMO circuit's retrograde flow can distend the non-ejecting LV, both requiring active monitoring.

Question 4

Which finding on chest X-ray after cardiac surgery suggests tension pneumothorax requiring immediate decompression?

Accepted Answer

Tracheal deviation away from the affected side with absent lung markings and hemodynamic instability

Answer

Tension pneumothorax causes tracheal deviation away from the collapsed lung, absent breath sounds, and cardiovascular collapse requiring immediate needle decompression.

Question 5

The diameter threshold that generally triggers surgery for an ascending aortic aneurysm in a patient with a bicuspid aortic valve is:

Accepted Answer

5.5 cm (or 5.0 cm with additional risk factors)

Answer

Current guidelines recommend surgery for bicuspid aortic valve-associated ascending aneurysms at 5.5 cm, or at 5.0 cm when risk factors such as rapid growth or family history are present.

Cardiac Surgery Certification Exam Practice Test

Cardiac Surgery Certification Exam Practice Test

Cardiac Surgery Certification Exam Aortic Surgery and Mechanical Circulatory Support 2